Association between Social Jetlag and glycemic control in diabetic patients at King Saud University Medical City

Introduction: Social Jetlag has been linked to many cardiovascular and metabolic diseases, as it disturbs the circadian rhythm. Methodology: case-control matched by age and gender conducted among 511 subjects. Control group: Diabetic with HbA1c <7.5%, while cases: Diabetic with HbA1c 7.5% or more. We used Munich Chronotype Questionnaire to assess the Social Jetlag. Results: Social Jetlag status was similar among both cases and control participants which indicate that there was no significant association between Social Jetlag and HbA1c (P-value = 0.394). The prevalence of Social Jetlag in the studied population is 58.4%. Conclusion: We suggest future studies to have a more precise estimation of sleep duration and Social Jetlag and focusing on Social Jetlag and its related problems

Impact of an electronic alert system for pediatric sepsis screening: a tertiary hospital experience

Abstract Objectives This study aimed to assess the potential impact of implementing an electronic alert system (EAS) for systemic inflammatory syndrome (SIRS) and sepsis in pediatric patients mortality. Method This retrospective study had a pre and post design. We enrolled patients aged ≤ 14 years who were diagnosed with sepsis/severe sepsis upon admission to the pediatric intensive care unit (PICU) of our tertiary hospital from January 2014 to December 2018. Intervention We implemented an EAS for the patients with SIRS/sepsis. The patients who met the inclusion criteria pre-EAS implementation comprised the control group, and the group post-EAS implementation was the experimental group. Mortality was the primary outcome, while length of stay (LOS) and mechanical ventilation in the first hour were the secondary outcomes. Results Of the 308 enrolled patients, 147 were in the pre-EAS group and 161 in the post-EAS group. In terms of mortality, 44 patients in the pre-EAS group and 28 in the post-EAS group died (p 0.011). The average LOS in the PICU was 7.9 days for the pre-EAS group and 6.8 days for the post-EAS group (p 0.442). Early recognition of SIRS and sepsis via the EAS led to faster treatment interventions, which included fluid boluses (163.42 ± 107 vs. 100.85 ± 30, p 0.014) and the initiation of antimicrobial therapy (303.06 ± 451 vs. 198.94 ± 214, p 0.011). The difference in mechanical ventilation in the first hour of admission was not significant between the groups (25.17% vs. 24.22%, p 0.895). Conclusion The implementation of the EAS resulted in a statistically significant reduction in the mortality rate among the patients admitted to the PICU in our study. An EAS can play an important role in saving lives and subsequent Reduction in healthcare costs. Further enhancement of systematic screening is therefore highly recommended to improve the prognosis of pediatric SIRS and sepsis and warrants further validation in multicenter or national studies.</jats:p

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population